Department of Anesthesia and Intensive Care, Faculty of Medicine, Assuit University, Assiut, Egypt.
1Assiut University, Assiut, Egypt.
Pain Physician. 2020 Mar;23(2):E175-E183.
Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy, which results from median nerve compression. A lot of nonsurgical modalities are available for the management of mild to moderate situations. Local Hyalase hydrodissection (HD) of the entrapped median nerve could offer a desirable sustained symptom alleviation.
To evaluate the clinical efficacy of Hyalase/saline solution carpal tunnel HD on pain, functional status, and nerve conduction in patients with CTS.
A randomized, double-blinded trial.
Anesthesia, pain, and rheumatology clinics in a university hospital.
Patients: 60 patients with CTS (> 6 months' duration).
patients were allocated equally into either group 1 (HD with Hyalase + 10 mL saline solution injection), or group 2 (HD with 10 mL saline solution only).
assessment of pain using Visual Analog Scale (VAS), functional disability (FD) score, and nerve conduction studies before injection, and over 6 months after injection. Nerve conduction parameters before injection and postinjection by the end of 3 and 6 months were evaluated as well.
Statistically significant lower postinjection values of VAS (1 ± 1.8, 2 ± 1.1, 2 ± 1.2, 2 ± 1.1) in group 1 versus (2 ± 1.2, 3 ± 1.7, 4 ± 1.5, 5 ± 2.6) in group 2 by the end of the first week, and the first, third, and sixth months, and significantly lower FD scores (15.3 ± 1.2, 13 ± 1.3, 10.2 ± 1.3, 10.2 ± 1.3) in group 1 versus (17.5 ± 1.8, 16.6 ± 2.8, 19.4 ± 3.2, 21.2 ± 2.5) in group 2 during the same time intervals. Nerve conduction study parameters have shown significantly higher velocity and lower latency in the Hyalase group than in the saline solution group by the 3 and 6 month follow-up.
We suggest a longer period could be reasonable.
Carpal tunnel HD with Hyalase with saline solution is considered as an efficient technique offering a rapid onset of pain relief and functional improvements, and better median nerve conduction in patients with CTS over 6 months follow-up duration.
Carpal tunnel syndrome, Hyalase, median nerve hydrodissection.
腕管综合征（CTS）是最常见的神经卡压综合征，由正中神经受压引起。有许多非手术方法可用于治疗轻中度情况。局部透明质酸酶水分离（HD）可提供理想的持续症状缓解。
评估透明质酸酶/盐水溶液腕管 HD 对 CTS 患者疼痛、功能状态和神经传导的临床疗效。
随机、双盲试验。
大学医院的麻醉、疼痛和风湿病诊所。
患者：60 例 CTS（>6 个月）患者。
患者平均分为两组 1（HD 加透明质酸酶+10ml 生理盐水注射）或组 2（HD 加 10ml 生理盐水）。
注射前和注射后 6 个月使用视觉模拟量表（VAS）评估疼痛、功能障碍（FD）评分和神经传导研究。注射后 3 个月和 6 个月还评估了神经传导参数。
组 1 的 VAS 值在注射后明显降低（1±1.8、2±1.1、2±1.2、2±1.1），而组 2 的 VAS 值在注射后明显升高（2±1.2、3±1.7、4±1.5、5±2.6），第 1 周和第 1、3、6 个月，FD 评分（15.3±1.2、13±1.3、10.2±1.3、10.2±1.3）明显低于组 2（17.5±1.8、16.6±2.8、19.4±3.2、21.2±2.5），同一时间间隔。神经传导研究参数显示，透明质酸酶组的速度明显高于盐水组，潜伏期明显低于盐水组，随访 3 个月和 6 个月。
我们建议更长的时间可能是合理的。
在 6 个月的随访期间，透明质酸酶联合盐水溶液腕管 HD 被认为是一种有效的技术，可快速缓解疼痛并改善 CTS 患者的功能，改善正中神经传导。
腕管综合征；透明质酸酶；正中神经水分离。
